病灶切除术联合药物治疗子宫腺肌病的临床分析  

Clinical Anaiysis of Lesion Resection Surgery Combined with Medicine in Treatment of Uterine Adenomyoma

作　　者：黄芳[1] 李琼珍[1] 陈中文[1] 欧丽红[1] 李玲[1] 

机构地区：[1]广东省肇庆市第一人民医院,广东肇庆526021

出　　处：《中国医学创新》2017年第27期63-66,共4页Medical Innovation of China

基　　金：广东省肇庆市科技创新计划项目(2013E231)

摘　　要：目的:比较单纯子宫腺肌病病灶切除术与病灶切除术后联合药物(促性腺激素释放激素激动剂及孕三烯酮)治疗子宫腺肌病的临床效果。方法:选取2013年5月-2016年1月本院收治的60例子宫腺肌病患者为研究对象,分为A、B和C组,每组20例。A组行病灶切除术后予肌注促性腺激素释放激素激动剂(Gn RH-a)治疗;B组术后口服孕三烯酮治疗;C组仅行单纯病灶切除术。比较三组治疗后的痛经程度、月经量情况、复发率及药物副反应发生情况。结果:治疗后,A、B组痛经缓解及消失率均高于C组,差异均有统计学意义(P<0.05),而A组与B组比较,差异无统计学意义(P>0.05)。治疗后,A、B两组的月经减少率均低于治疗前,差异均有统计学意义(P<0.05);C组治疗前后月经减少率比较,差异无统计学意义(P>0.05)。A组和B组的不良反应发生率比较,差异无统计学意义(P>0.05)。治疗后2年内,A组复发率低于B、C组,差异均有统计学意义(P<0.05),B组和C组比较,差异无统计学意义(P>0.05)。结论:病灶切除手术后无论是否辅助药物治疗均能有效治疗子宫腺肌病,术后辅助Gn RH-a药物治疗能更有效控制临床症状、减少疾病复发。对于经济困难或不能耐受Gn RH-a药物不良反应者口服孕三烯酮是不错的选择,但需要注意肝功能的保护。Objective： To compare the clinical effects of combined resection of uterine adenomyosis with resection of lesion and combination of drugs （ Gonadotropin Releasing Hormone Agonist and Gestrinone ） on adenomyosis.Method： A total of 60 cases of uterine adenomyoma who had lesion resection surgery in our hospital from May 2013 to January 2016, they were divided into group A, B and C, 20 cases in each group.Group A was treated with lesion resection surgery plus GnRH-a, group B was treated with lesion resection surgery plus oral gestrinone, group C was treated with lesion resection surgery alone.The degree of dysmenorrheal, menstrual quantity, recurrence rate and drug side effects of three groups were compared.Result： After treatment, the remission rate and disappearance rate of dysmenorrhea in group A and B were higher than those in group C, the differences were statistically significant （ P〈0.05 ）, but there was no significant difference between the group A and group B （ P〉0.05 ） .After treatment, the menstruation reduction rate of group A and B were lower than those before treatment, the differences were statistically significant （ P〈0.05 ） ; before and after treatment, the hypomeuorrhea rate comparison of group C were compared, the difference was not statistically significant （ P〉0.05 ） .There was no significant difference in the incidence of adverse reactions between the group A and group B （ P〉0.05 ） .Within 2 years after treatment, the recurrence rate in group A was lower than those in group B and C, the differences were statistically significant （ P〈0.05 ）, there was no significant difference between group B and group C （ P〉0.05 ） . Concluslon： Lesion resection surgery with or without adjuvant medical therapy can effectively treat uterine adenomyoma.Adjuvant GnRH-a therapy is more effective in controlling symptoms and reducing disease recurrence. For patients with economic problems or those who can＇t tolerate the side effects of GnRH-a drugs, oral gestrinon

关 键 词：子宫腺肌病 病灶切除术 促性腺激素释放激素激动剂 孕三烯酮 

分 类 号：R711.71[医药卫生—妇产科学]